Age, Income Tied to Youth Adherence to ADA Guidelines

Youths older than 18 years, especially those with type 2 diabetes, undergo fewer tests of all types

MONDAY, Aug. 29 (HealthDay News) -- Overall adherence of youth to the American Diabetes Association (ADA) testing guidelines is good and is correlated with age and family income, with older age and lower income associated with non-adherence, according to a study published online Aug. 22 in Pediatrics.

Beth Waitzfelder, Ph.D., from the Pacific Health Research Institute in Honolulu, and colleagues investigated the demographic and clinical characteristics associated with self-reported quality of care (tests and measurements recommended by the ADA guidelines) for diabetes in 1,514 SEARCH for Diabetes in Youth study participants. A composite variable was created for five ADA guideline-based quality-of-care measures: eye examinations, glycohemoglobin (hemoglobin A1c [HbA1c]), lipid level, microalbuminuria, and blood pressure measurements. Association of demographic and clinical characteristics with reported receipt of recommended tests and measurements, according to age and diabetes type subgroups, was evaluated using multivariate logistic regression analyses.

The investigators found that 95 percent of the participants reported undertaking blood pressure measurements at most or all visits, and 88, 83, 68, and 66 percent underwent lipid level measurements, kidney function testing, HbA1c testing, and eye examinations, respectively, in accordance with recommendations from the ADA. Fewer tests of all types were performed for participants aged 18 years or older, particularly in those with type 2 diabetes. Age and family income were significantly associated with quality-of-care measures, with lower income and older age associated with non-adherence to guidelines.

"Although there was relatively good adherence to ADA-recommended guidelines for most indicators, efforts are needed to improve rates of HbA1c testing and eye examinations, particularly among older youths," the authors write.

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